Hui T, Rozga J, Demetriou A A
Department of Surgery, Cedars-Sinai Medical Center, UCLA School of Medicine, Los Angeles, CA 90048, USA.
J Hepatobiliary Pancreat Surg. 2001;8(1):1-15. doi: 10.1007/s005340170045.
Orthotopic liver transplantation is the only definitive therapy for patients with fulminant hepatic failure (FHF). However, due to shortage of organs, a large number of patients die before a liver can be procured for transplantation. In FHF the need for a liver is particularly urgent because of rapid deterioration in the patients' condition with the onset of cerebral edema and intracranial hypertension leading to irreversible brain damage. It is thus necessary to develop an extracorporeal liver support system to help maintain patients alive and neurologically intact until an organ becomes available for transplantation. Multiple attempts have been made, ranging from the use of plasma exchange to utilization of charcoal columns and extracorporeal devices loaded with liver tissue to develop liver support systems for treating patients with acute severe liver failure. None of these systems has achieved wide clinical use, and FHF due to multiple causes continues to be associated with significant morbidity and mortality. In this paper, the authors review the history of extracorporeal liver support for acute liver failure and discuss their experience with a hollow fiber bioartificial liver support system utilizing porcine hepatocytes in the treatment of patients with acute liver failure.
原位肝移植是暴发性肝衰竭（FHF）患者的唯一确定性治疗方法。然而，由于器官短缺，大量患者在获得可用于移植的肝脏之前死亡。在FHF中，由于患者病情迅速恶化，出现脑水肿和颅内高压，导致不可逆的脑损伤，对肝脏的需求尤为迫切。因此，有必要开发一种体外肝支持系统，以帮助患者维持生命和神经功能完整，直到有可用的移植器官。人们已经进行了多次尝试，从使用血浆置换到利用炭柱以及装载肝组织的体外装置来开发用于治疗急性重症肝衰竭患者的肝支持系统。这些系统均未得到广泛的临床应用，多种原因导致的FHF仍然与显著的发病率和死亡率相关。在本文中，作者回顾了急性肝衰竭体外肝支持的历史，并讨论了他们使用中空纤维生物人工肝支持系统（利用猪肝细胞）治疗急性肝衰竭患者的经验。
